{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T05:06:48Z","timestamp":1784696808135,"version":"3.55.0"},"reference-count":26,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T00:00:00Z","timestamp":1784678400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Med."],"abstract":"<jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To evaluate the effects of continuous care delivered via a mobile health (mHealth) platform on self-management behaviors, quality of life (QoL), medication adherence, psychological distress, daytime sleepiness, cancer-related fatigue (CRF), complications, and rehospitalization in patients with acute leukemia (AL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A total of 108 AL patients discharged between January 2024 and January 2025 were randomly assigned to an observation group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f54) receiving mHealth-based continuous care plus routine follow-up, or a control group (\n                      <jats:italic>n<\/jats:italic>\n                      \u202f=\u202f54) receiving routine continuous care only. The intervention lasted 6\u202fmonths. Seven patient-reported outcome scales were assessed at baseline, 3\u202fmonths, and 6\u202fmonths: self-management behavior (SUPPH with three subscales), QoL (EORTC QLQ-C30 global health status and five functional subscales), medication adherence (MMAS-8), anxiety (SAS), depression (SDS), daytime sleepiness (ESS), cancer-related fatigue (PFS with four subscales). Complications and rehospitalization were recorded throughout the 6-month period. Complications and unplanned rehospitalization were prospectively recorded as cumulative endpoints throughout the 6-month intervention period. For repeated measures, two-way repeated measures ANOVA (group \u00d7 time) was applied.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Significant group \u00d7 time interactions were observed for all continuous variables (all\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). At 3 and 6\u202fmonths, the observation group showed progressively better scores. For example, SUPPH total score at 6\u202fmonths: 86.42\u202f\u00b1\u202f6.13 vs. 71.25\u202f\u00b1\u202f8.54 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001); QLQ-C30 global health status: 78.36\u202f\u00b1\u202f7.21 vs. 62.45\u202f\u00b1\u202f9.18 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001); MMAS-8: 7.18\u202f\u00b1\u202f0.75 vs. 6.05\u202f\u00b1\u202f1.21 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001); SAS: 45.21\u202f\u00b1\u202f4.13 vs. 50.36\u202f\u00b1\u202f5.02 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001); SDS: 46.38\u202f\u00b1\u202f5.22 vs. 53.19\u202f\u00b1\u202f5.64 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001); ESS: 7.32\u202f\u00b1\u202f2.15 vs. 11.68\u202f\u00b1\u202f3.04 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001); PFS total: 3.25\u202f\u00b1\u202f1.02 vs. 5.73\u202f\u00b1\u202f1.48 (\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). All subscales followed similar patterns. Complication rate (11.11% vs. 29.63%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.016) and rehospitalization rate (7.41% vs. 24.07%,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.012) were lower in the observation group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Continuous care based on an mHealth platform significantly improves self-management, QoL, medication adherence, psychological outcomes, daytime sleepiness, and fatigue at 3 and 6\u202fmonths, and reduces complications and rehospitalizations in this single-center cohort of AL patients. These findings require multicenter validation in more diverse populations.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fmed.2026.1880270","type":"journal-article","created":{"date-parts":[[2026,7,22]],"date-time":"2026-07-22T04:49:18Z","timestamp":1784695758000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of continuous care based on a mobile health platform on self-management behaviors and quality of life in patients with acute leukemia"],"prefix":"10.3389","volume":"13","author":[{"given":"Wulipaxi","family":"Habasi","sequence":"first","affiliation":[{"name":"Disinfection and Distribution Center, The First Affiliated Hospital of Xinjiang Medical University","place":["Urumqi, Xinjiang, China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayinaer","family":"Shaheba","sequence":"additional","affiliation":[{"name":"Disinfection and Distribution Center, The First Affiliated 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leukaemia","volume":"401","author":"DiNardo","year":"2023","journal-title":"Lancet"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"e577","DOI":"10.1038\/bcj.2017.53","article-title":"Acute lymphoblastic leukemia: a comprehensive review and 2017 update","volume":"7","author":"Terwilliger","year":"2017","journal-title":"Blood Cancer J"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"1417","DOI":"10.1001\/jamaoncol.2024.2662","article-title":"Contemporary Management of Acute Myeloid Leukemia: a review","volume":"10","author":"Venugopal","year":"2024","journal-title":"JAMA Oncol"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"731","DOI":"10.1016\/j.leukres.2013.02.009","article-title":"Symptom burden and supportive care in patients with acute leukemia","volume":"37","author":"Zimmermann","year":"2013","journal-title":"Leuk Res"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"e44533","DOI":"10.2196\/44533","article-title":"A Mobile app to support self-Management in Patients with multiple myeloma or chronic lymphocytic leukemia: pilot randomized controlled trial","volume":"9","author":"LeBlanc","year":"2023","journal-title":"JMIR Cancer"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"101306","DOI":"10.1016\/j.blre.2025.101306","article-title":"Advances in the critical care management for patients with hematological malignancies","volume":"74","author":"Azoulay","year":"2025","journal-title":"Blood Rev"},{"key":"ref7","doi-asserted-by":"publisher","first-page":"4129","DOI":"10.1002\/cncr.34476","article-title":"Infectious events in pediatric patients with acute lymphoblastic leukemia\/lymphoma undergoing evaluation for fever without severe neutropenia","volume":"128","author":"Patel","year":"2022","journal-title":"Cancer"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"e23","DOI":"10.2196\/mhealth.8873","article-title":"The impact of mHealth interventions: systematic review of systematic 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Care"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"2713","DOI":"10.1007\/s10067-022-06195-y","article-title":"Reliability and validity of the Chinese version of the eight-item Morisky medication adherence scale in Chinese patients with systemic lupus erythematosus","volume":"41","author":"Shi","year":"2022","journal-title":"Clin Rheumatol"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1001\/archpsyc.1965.01720310065008","article-title":"A SELF-RATING DEPRESSION SCALE","volume":"12","author":"Zung","year":"1965","journal-title":"Arch Gen Psychiatry"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"371","DOI":"10.1016\/s0033-3182(71)71479-0","article-title":"A rating instrument for anxiety disorders","volume":"12","author":"Zung","year":"1971","journal-title":"Psychosomatics"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"216","DOI":"10.1177\/089198879400700404","article-title":"The Zung self-rating depression scale: screening for depression among the Hong Kong Chinese elderly","volume":"7","author":"Lee","year":"1994","journal-title":"J Geriatr Psychiatry Neurol"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"540","DOI":"10.1093\/sleep\/14.6.540","article-title":"A new method for measuring daytime sleepiness: the Epworth sleepiness scale","volume":"14","author":"Johns","year":"1991","journal-title":"Sleep"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1023\/a:1020818417949","article-title":"Validation of a Chinese version of the Epworth sleepiness scale","volume":"11","author":"Chen","year":"2002","journal-title":"Qual Life Res"},{"key":"ref21","first-page":"677","article-title":"The revised Piper fatigue scale: psychometric evaluation in women with breast cancer","volume":"25","author":"Piper","year":"1998","journal-title":"Oncol Nurs Forum"},{"key":"ref22","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1097\/00002820-200306000-00006","article-title":"Fatigue and quality of life among Chinese patients with hematologic malignancy after bone marrow transplantation","volume":"26","author":"So","year":"2003","journal-title":"Cancer Nurs"},{"key":"ref23","doi-asserted-by":"publisher","first-page":"2853","DOI":"10.1007\/s00520-021-06568-0","article-title":"Effectiveness of mobile health-based self-management interventions in breast cancer patients: a meta-analysis","volume":"30","author":"Luo","year":"2022","journal-title":"Support Care Cancer"},{"key":"ref24","doi-asserted-by":"publisher","first-page":"e31756","DOI":"10.1002\/pbc.31756","article-title":"Human-centered design of a personalized digital health intervention to improve oral chemotherapy adherence in adolescents and young adults with hematologic cancers","volume":"72","author":"Psihogios","year":"2025","journal-title":"Pediatr Blood 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